Cost—Utility Analysis of an Integrated Genetic/Epigenetic Test for Assessing Risk for Coronary Heart Disease

Abstract

Aim: New epigenetically based methods for assessing risk for coronary heart disease may be more sensitive but are generally more costly than current methods. To understand their potential impact on healthcare spending, we conducted a cost–utility analysis. Methods: We compared costs using the new Epi + Gen CHD™ test with those of existing tests using a cohort Markov simulation model. Results: We found that use of the new test was associated with both better survival and highly competitive negative incremental cost–effectiveness ratios ranging from -$42,000 to -$8000 per quality-adjusted life year for models with and without a secondary test. Conclusion: The new integrated genetic/epigenetic test will save money and lives under most real-world scenarios. Similar advantages may be seen for other epigenetic tests.

Keywords::

• coronary heart disease
• cost–utility analysis
• DNA methylation
• economics
• epigenetics
• precision medicine

Financial & competing interests disclosure

The University of Iowa has filed intellectual property claims related to the integrated genetic/epigenetic technology described in this communication (US Patent application 62,455,416: Compositions and Methods for Detecting Predisposition to Cardiovascular Disease) on behalf of M Dogan and R Philibert. Notice of intent for allowance for this application has been made by the European Patent Office. In addition, M Dogan, R Philibert and T Dogan, Cardio Diagnostics Inc., have filed intellectual property claims related to the integrated genetic/epigenetic technology described in this communication (US Patent application 63,074,878: Methods and Compositions for Predicting Coronary Heart Disease). M Dogan is the Chief Executive Officer and stockholder of Cardio Diagnostics Inc.; R Philibert is the Chief Medical Officer and stockholder of Cardio Diagnostics Inc.; T Dogan is an employee and stockholder of Cardio Diagnostics Inc. (www.cardiodiagnosticsinc.com). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.